For Indians too poor to buy heroin, neighborhood pharmacists are willing dealers, further entrenching a cycle of addiction, infection, and death

An injecting drug user (IDU) fills a syringe with buprenorphine on a roadside in Chandigarh / Reuters

NEW DELHI,
India -- Dharminder was just 17 years old when his half-naked body was
found one morning in an alley near Jahangirpuri station, the northern
terminus of the New Delhi Metro's yellow line. The teen's body was slung
onto a vegetable cart and covered with a blanket that left his bare
toes exposed as he was wheeled down the main road leading from the Metro
station to the morgue.

Dharminder's official autopsy from Babu
Jagjivan Ram Memorial Hospital describes various external injuries to
his ribs, chest, abdomen, and shoulders, caused by a "blunt" implement.
On arrival, he was wearing "pants only, soiled with fecal matter." The
document guesses his age incorrectly at 18 or 19, but it doesn't matter.
Dharminder was a junkie, and the locals disparage junkies -- they
steal, they carry disease; they're untouchable beyond caste.

No
one is exactly sure how he expired, but 23-year-old Nikhil Kumar, who
works in a nearby metal-cutting shop, believes Dharminder was beaten to
death by three other junkies the night before his body was discovered.
Whether it was for the drugs or money he may have been hoarding, no one
willing to talk knows for certain.

This area in northwest Delhi
is best known for the Azadpur Fruit and Vegetable Market, but across
National Highway 1, Jahangirpuri is home to another roaring industry:
hawking products with longer sell-by dates than the tons of bananas and
tomatoes that come through Azadpur: illicit pharmaceuticals. This is not
the only neighbourhood in Delhi with a drug problem -- areas like
Yamuna Bazar and Silampur are also notorious for the numbers of addicts
trawling their streets. What makes Jahangirpuri so dangerous is that,
here, the chemists are the drug dealers. This would be easy enough to
hide -- if the Jahangirpuri chemists who sell prescription
pharmaceutical drugs over the counter actually felt the need for
discretion. But they don't. It's as easy to obtain and shoot
pharmaceuticals here as it is to get a free meal at the nearby Sikh
temple and save money for another hit.

For Dharminder, like many before him and many others sure to follow, Jahangirpuri truly was the end of the line.

• • • • •

"Young
people get old here very quickly," says Rajiv, a 47-year-old ex-user
with a pronounced limp in his left leg, as he roots around in a hidden
compartment inside his blue track pants for a match to keep his beedi
going. He lights the undecided ember into a glow under his push-broom
moustache and exhales. "Here, in every house you have a junkie."

Rajiv
would know. After years of drug abuse, he has been staying at a centre
in Saket, in South Delhi, run by Sahara, an NGO that treats and houses
injecting drug users. Sahara opened a treatment centre in Jahangirpuri
in 2001, and in 2006 received expanded funding as part of the United
Nations Office on Drugs and Crime's (UNODC) Project H13, intended to
curb the spread of HIV/AIDS in South Asian countries. But it didn't last
long -- as Mike Marshall, the former director of projects at Sahara,
tells me, "All UNODC projects in India lost their funding and had to
close due to the global recession."

There has been no recession,
however, for those who cater to the addictions of India's abject.
Chemists here know what users need, and they have conveniently bundled
the requisite gear into a kind of Japanese bento box: one
two-milliliter ampule of diazepam, a tranquillizer better known as
Valium, also used to stop seizures and aid in alcohol withdrawal; one
two-millimeter ampule of buprenorphine, a synthetic opioid like
methadone used to treat addiction to opiates; and one two-milliliter
bottle of Avil, an antihistamine meant to be injected intramuscularly
(though many users prefer a 10-milliliter bottle so they can use the
larger receptacle to mix all three drugs); one syringe; and two
detachable needles. Users say the antihistamine is good for preventing
rash, but it's mostly to increase the volume of a shot. One Jahangirpuri
chemist, to attract new customers, has begun to throw in a digestif of a
Netrovet-10 tablet, a strong sedative. A set costs 50 to 60 rupees,
about one dollar.

Before Sahara shut its doors here, this is
where Rajiv spent most of his reclaimed time after his withdrawal
period, doing the legwork he and other independent aid workers describe
as crucial: knocking on doors and talking to families who have no idea
how to stop this surge of over-the-counter pharmaceuticals from stealing
away their loved ones.

Rajiv, like the independent aid workers
who have effectively, albeit unofficially, replaced Sahara and H13, says
that the door-to-door canvassing is the only thing they see making a
real difference.

"Dharminder's case is very common," an aid
worker whom I'll call Sita later tells me. "We find dead kids on the
sides of the road here all the time."

Dharminder left the town
of Harpalpur in Uttar Pradesh when he was 12, already sniffing away his
pick-pocketing profits in glue and solvents. In Jahangirpuri, he
scavenged for scrap metal and took advantage of the tight-packed
transience in the sprawling Azadpur market to reappropriate carelessly
placed wallets. Before he died, Dharminder told me he made 50 to 100
rupees, about one to two U.S. dollars, a day.

Rajiv takes
shelter from the afternoon sun near the alley where Dharminder's body
was found. National Highway 1 and its last run of elevated Metro line
are a few hundred feet away, just after a stretch of houses that look as
if something has bitten their fronts off; just past where the truckers
park and bring local, often casual, prostitutes to assuage the
loneliness of the road. A little further east are the various recyclers
who buy the materials from scavengers, who often then circle back to an
alley adjacent to Mahendra Park to shoot up. Then it's back across the
road to scour Azadpur for enough money to complete the circuit again.

Before
long, an elderly woman nearby recognizes Rajiv and hurries over with a
frantic tale, pointing to her son, who is rocking on his haunches in
front of a nearby door. Rajiv explains something quietly to the child --
he can't be more than 13 or 14 tops -- who plants his forehead on his
knee-hugging arms and begins to cry. Laying out the consequences that
await users, Rajiv proffers himself as an example, pointing to his leg
with the limp.

Neju, a junkie from an older generation, scampers
over and squats, opening the buttons of his grease-sheened shirt to
show Rajiv how his shoulder has healed. Most of the cap's muscle, where
an abscess had been successfully removed, looks like an old shark bite.
Sita tells me that abscess management is a big part of their work --
much more than detoxification. According to a UNODC report from April
2009, Sahara treated abscesses in up to 30 people per month in
Jahangirpuri. This cauterized circuitry is Neju's good news to share. As
he shows off his healed shoulder, a long knife falls from the left
pocket of his pants.

"Put that away," Rajiv scolds him.

"It's
for cutting fruit," replies Neju, who credits his longevity to his
moderate pharmaceutical intake. He files the blade back into his pocket.

"Probably true," whispers Rajiv. "For real fights, they keep a
surgical blade that'll cut you to the bone hidden in their mouths."

The
woman thanks Rajiv for his counsel and takes his card as she leads her
son away. This boy is one of the more fortunate addicts. He has a home:
access to regular meals means his rate of decay will be slower than
those who sleep on these streets. For him, there's no competition with
fellow scavengers at the end of a hard day's work to divvy up the
remains of a pharma cocktail and be tempted to take that little bit more
than he should. Maybe that's what killed Dharminder.

A
look at any survey by either a government or non-government agency
shows that HIV/AIDS transmission in India involves three primary
cohorts: sex workers, truckers, and injecting drug users (IDUs).
Jahangirpuri's concentration of all three high-risk groups makes it a
locus of India's HIV problem. The truckers who may contract the disease
here will soon be on the road to all corners of the country, while many
Jahangirpuri-area prostitutes -- by one count, almost 600 have tested
HIV-positive -- will return home to their families, and be back in
Azadpur market the next day for the night shift, and the next round of
truckers.

A Project H13 survey from 2008 and 2009 found that 98
percent of all IDUs in Jahangirpuri were men, who by virtue of proximity
to Azadpur and its free flow of drugs have had easy access to heroin, a
party favor for many in the 1980s. It was the chemists providing
pharmaceuticals over the counter to men with expensive heroin addictions
that created the IDU epidemic in the mid-1990s. Rajiv, along with every
recovering addict in Sita's care, tells a similar story. They'd drink
with friends, then someone would suggest they smoke some heroin, which
would soon become regular beyond the point of weekend recreation. That
would get too expensive, and so pharmaceuticals were the next logical
step. Even after business hours, a couple of pharmacists would sell the
drugs from their homes, providing 24-hour access. Some still do.

Rajiv
tells me that the only time you'll see dealers on the streets is when
there's a shortage in the pharmacies. That hasn't happened "in quite a
while", says Urdip, a 45-year-old autorickshaw driver, as he sits in
Sita's centre with one leg tucked under the other, leaning against the
wall, his shoulders in line with the ring of accumulated filth that
demarcates the sitting area. "It feels good to get away from drugs," he
leans in to tell me, though he knows that at this stage, just going out
on the street would be too great a temptation to shoot up again.

According
to the World Health Organization, an IDU's full physical recovery can
take up to three years. But "the craving never dies in the mind", Rajiv
admits, squinting one eye from the smoke of another beedi.

"These
people come from the lowest castes," Rajiv explains, "so the women
don't have the social freedom to go to the wine shop or to the chemist
like the men. A lot of them still have to stay inside with their heads
covered. ... The husband doesn't give a fuck about the house, kids, but a
woman will be more sensitive to the needs of the children, to taking
care of the children. She may whore to make money, but she won't
inject."

Either way, HIV/AIDS is here, whether it comes from the
area's drug use or prostitution or whether it's transferred from one
partner to another as a result of the drug use or prostitution. I
accompany Sita to the nearby hospital, Babu Jagjivan Ram, to pick up the
results of her HIV test. She's negative, but most women in the area,
she tells me, have to sneak away to avail themselves of the free HIV
testing at the hospital. Should they test positive, Sita says, they are
rarely able to undergo the continued treatment required because they
keep the results hidden from their families. Locals and aid workers say
street junkies are not welcome at the hospital, unless, of course, it's
to the separate building at the back where their corpses are
incinerated.

The National AIDS Control Organization estimates
the number of HIV-positive IDUs in India at eight percent of the
population, but most involved feel the number in Delhi, especially in
Jahangirpuri, will turn out to be much higher. As the first group to
gather specific numbers, Sahara, in conjunction with other groups, has
begun a two-year research project in five Delhi neighbourhoods suffering
from endemic drug use, but until they're done, there are still no hard
figures on how many IDUs there are in Jahangirpuri, or how many are HIV
positive.

When I return to Sita's new centre, three more
addicts, along with Urdip, have sought her out. They all sit against the
concrete, their varying shoulder heights contributing to the wall's
dark stripe. Like the boy whose mother approached Rajiv, these men now
detoxing had the advantage of a home and relative nutrition, but they're
getting old. They look dejected. They look ill. Their stories vary, but
they overlap more. These men want to get clean for their families. They
want to start working again.

• • • • •

Moti,
one of the homeless addicts, squats under one of the pillars of the
Metro line that runs down the middle of National Highway 1, wearing a
once-black-and-white shirt, now all grey, once-grey pants now mostly
black. He scratches at his left shoulder with a bloated right hand. No
veins are visible, just a rough, scaly surface, like a series of closed
scabs. He wobbles to his feet and crosses the southbound lanes into an
alley adjacent to Mahendra Park. From a distance, the scene is typical
of urban India, rubbish collected into little multicolored ghats
between the pavement and the brick walls on either side, but here, among
the candy wrappers and empty pouches of PassPass, are an equal number
of plastic syringe wrappers, more empty bottles with syringe-friendly
caps, and even more broken glass ampules. Clumps of human turds bake in
the sun and the ammonia smell of piss is overpowering. There are no
syringes, however, Moti determines. He's been rustling around trying to
find one hidden in the detritus to use for his afternoon fix.

He
is joined almost immediately, as if telepathically, by Rajinder, another
homeless man in his mid-40s. Rajinder is wearing only plastic sandals
and beige trousers, barely held up by his pelvis, the skin of his
stomach sagging like an old shirt on the hanger of his hip bones. He has
also been scavenging through the macaroons of shit and the tumbleweeds
of garbage, and confirms that there are no syringes lying around.
Rajinder reaches into the secret compartment inside his trousers, pulls
out a few moist 10-rupee notes and disappears.

Moti describes
himself as a ragpicker and says he needs a shot in the morning to be
able to do the work, then this lunchtime dose before the next round of
scavenging -- the nimble digits required for pick-pocketing in Azadpur
long swollen and atrophied -- and then another shot in the evening to
complete his circuit. It's a short one.

Rajinder returns from
the chemist, sits down, breaks open an ampule of buprenorphine and
extracts the liquid with his acquired syringe. He pushes the needle
through the opening in the cap of the Avil bottle and the two drugs are
mixed.

For a new addict, the arms are the usual starting point;
then it's on to the legs, the buttocks, the neck. Rajinder, who has
mostly destroyed his circulation in these areas, loosens his pants and
pulls them down to the hilt of his penis, leans against the wall and
sticks the needle into his groin. The skin resists a little before
snapping around the needle's tip. As the out-flowing blood fills the
syringe salmon pink, his breathing slows and he becomes visibly relaxed
the instant his thumb can't push any further on the plunger.

Moti
has no choice now, unable to find a shootable vein anywhere after years
of abuse, but to go intramuscular. And yet, the two addicts have been
relatively smart. They're not using the oil-based diazepam, which
quickly causes abscesses. Moti's already got a nasty one on his leg. But
going intramuscular is very risky. "You know when you go to the
doctor," says Rajiv, "and he puts a needle in your upper butt, your hip
or your bicep? That's because those muscles are always in use. Shooting
into a secondary muscle like the triceps could easily cause another
abscess."

Rajinder takes a few pokes and prods into Moti's upheld triceps before finding satisfactory purchase and injecting him.

When
I speak later with Dr. Rajat Ray, chief of the All India Institute of
Medical Sciences' National Drug Dependence Treatment Centre, he tells me
that Moti's is a severe case. The way in which Moti has been shooting
up all this time is what burns out the veins to the point of sepsis: the
repeated, unskilled and unsanitary injections that render
advanced-stage users' limbs vascularly barren.

The
two addicts sit for a few minutes, before getting up and stumbling out
of the alley, back across the road and into the shade under the Metro
line. They say it's more comfortable there, with the passing cars and
trucks for their air-conditioning.

Left in the alley, Rajiv
begins to pick up some of the drug packaging, some of which appears to
have travelled from as far as the truckers who pass through the area --
Uttar Pradesh, Uttarakhand, Maharashtra. One receptacle is from fairly
close to home: an empty bottle of Avil, made by Paksons Pharmaceuticals
in Haryana.

Founded over 20 years ago by Sushil Aggarwal,
Paksons produces just about every kind of prescription drug outside of
those employed in cancer treatment. The company's injectable drugs plant
is in Bahadurgarh, a 30-km drive west of Delhi, and Aggarwal is willing
to provide a guided tour. Behind the gates painted with Hindu swastikas
and past the garlanded images of Hindu gods, a series of rooms runs
clockwise around the ground floor of the building, where the drugs are
produced, tested, sterilely packaged, and shipped.

Aggarwal
points out that the factory is constantly being visited by incognito
representatives of government ministries. "They come every month,
sometimes every two weeks, to inspect," he says. "They come so often I
don't know which ministries they are from anymore."

Aggarwal
says he has little control over his drugs ending up in the veins of
junkies. For producers like him, there's another problem, one that he
tells me has kept him in court for seven years.

"One day in
2003," he begins, standing in the quality control room, raising his
voice over the tingling of ampules like thousands of tiny wind-blown
chandeliers, "my distributor called me and asked why I was selling a
certain drug in a market in Uttar Pradesh. I told him I didn't sell to
that market, and that the drug was not even being produced anymore."

Aggarwal
says he went to Bareilly, a city of just under a million people, to
investigate. With the local police, he found the seller using the
Paksons name to sell knock-offs of his drugs. The man was arrested and a
copyright infringement case was filed. It is still pending.

"Why
does it take seven years?" he asks, lifting his hands off the steering
wheel and opening them to the ceiling, as if asking Krishna to intervene
on the drive back to Delhi. "Because I don't pay money," he answers
himself. "But police, they take money. ... It's a big problem."

• • • • •

Rajiv
looks out across the roofs of passing buildings as the Metro's yellow
line recedes from the end of its route, back south towards another Delhi
-- Azadpur market on one side, Mahendra Park on the other, Moti and
Rajinder underneath.

Rajiv seems all the more fragile once the
train reaches busier stops and people crowd in around him, not aware of
how easily he could be injured. "I can't walk around for too long," he
says, crossing his left leg over his right. "All the blood goes to my
foot and my leg doesn't really have a way to bring it back up. I'll have
to lay down for a while when I get back to the centre."

As a
manager in a garment company, Rajiv had gotten into heroin during his
late 20s and early 30s, smoking "brown sugar" with friends at parties.
To save money, he downgraded to morphine and eventually to the same
vein-sizzling sets sold in Jahangirpuri. He was forced to stop after he
spiked his femoral artery on his inner-left thigh and ruptured it --
short-circuiting the blood flow to his left leg. "Before the CT Scan at
LNJP Hospital, the nurses had to call the senior doctor in because they
couldn't find a vein," says Rajiv calmly. "He eventually found one in my
neck."

He pulls up his left pant leg and exposes dry scales and
whorls of would-be abscesses that he has to monitor carefully. "If I
get a cut, it won't heal. There's no blood flow. If I break a bone, I'll
have to amputate it."

• • • • •

You'd
think that chemists selling illicit substances directly over the
counter to obvious addicts would be cagey and nervous in their work. Not
so for 50-year-old Vijay Ramesh, the owner of Dumpak Medicals, a nearby
chemist's. (Both his name and that of his shop have been changed.) He
arrives in Mahendra Park, adjacent to Moti and Rajinder's squalid alley,
accompanied by Birendra, who does not want to give his real name
because he works in Delhi's municipal corporation. From a distance,
Birendra looks like any average Delhiite -- moustache, side-parted hair,
slacks -- but as he gets closer, the telltale signs of light scar
tissue inside his forearm and a bloated hand give it away. He's an
addict, too.

The pair sits in the shade of a tree, their backs to
the highway. "The addicts who live on the street buy from me," Ramesh,
the chemist shop owner, tells me. "The area is such that I sell more IDU
drugs than I do cough medicine." He takes off his shades and twirls one
of the arms between his thumb and index finger. "Sure, addiction to
anything is bad, but it's a business."

Ramesh, who resembles a
subcontinental Steve Buscemi, says he operates with total confidence.
Chemists are required by law to keep records of all their sales of
controlled substances, but Ramesh says nobody does. Even if licensed
drugs were accounted for, there are many grades of suppliers to round
out the stock. "Suppliers make drugs in their homes, you don't know if
it's legitimate. People make it in huts, the demand is so high."

At
the Mahendra Park Police Station, Kaptaan Singh, the investigating
officer in 17-year-old Dharminder's case, admits that drugs are being
sold to junkies by the area's chemists. "Obviously," he says. "Where
else can they buy them?"

Rajiv could have told you that, but to
prove it, he sits behind a chemist in one of the local shops and
observes, "99.9 percent of the customers are junkies."

Ramesh
says he makes monthly payments to the police that go "all the way up. No
cop has the guts to [raid] my shop. They all get their money."

Ramesh
says there was a bit of a clampdown three years ago, but he hasn't had
any trouble from the police since then. And he can afford the monthly
kickbacks. "I charge 50 rupees for a set, and I sell between 100 and 300
sets a day," he says.

Officer Kaptaan Singh claims it's not his
job to bust the dealers and pins the responsibility on government drug
inspectors. It is not clear if they're from the same departments that
pay frequent visits to Paksons, and Dr. Surinder Singh, the Drugs
Controller General of India, declined to respond to multiple emails and
phone calls. His joint and deputy commissioners were equally unwilling
to talk.

• • • • •

Outside
Mahendra Park, as cars and trucks pass noisily and Metro trains slice
by overhead, a boy of about 12 or 13 spots Vijay Ramesh. The boy is
disheveled to the point of falling apart. There are lattices of slash
marks on his arms, and a stream of snot drips from his nose, over his
mouth to his chin. He's carrying an empty can of Godfather beer, and it
is in the manner of a mafia don that Ramesh accepts the boy's
supplications. "Uncle, uncle," the urchin pleads, touching his feet, "I
haven't had anything since morning."

Ramesh pats him on the head. "Go wait over there, I'll bring you something."

The
boy's loyalty is important in a business where many long-term users,
40- to 50-year-olds like Rajinder and Moti, are dying, and men like
Urdip are trying to get clean.

Ramesh waves at another passing
local as he turns into the lane to Dumpak Medicals, with Birendra, the
drug-addicted municipal employee, following close behind. The boy,
meanwhile, fidgets in the dust on the side of the road, scratching at
various parts of his body, waiting for Ramesh to get him through the
afternoon.

"See?" Ramesh says, his black shades back on, hiding his eyes. "Old people are dying, but young people are coming."Aside from Rajiv, names of all Jahangirpuri locals have been changed

Most Popular

Should you drink more coffee? Should you take melatonin? Can you train yourself to need less sleep? A physician’s guide to sleep in a stressful age.

During residency, Iworked hospital shifts that could last 36 hours, without sleep, often without breaks of more than a few minutes. Even writing this now, it sounds to me like I’m bragging or laying claim to some fortitude of character. I can’t think of another type of self-injury that might be similarly lauded, except maybe binge drinking. Technically the shifts were 30 hours, the mandatory limit imposed by the Accreditation Council for Graduate Medical Education, but we stayed longer because people kept getting sick. Being a doctor is supposed to be about putting other people’s needs before your own. Our job was to power through.

The shifts usually felt shorter than they were, because they were so hectic. There was always a new patient in the emergency room who needed to be admitted, or a staff member on the eighth floor (which was full of late-stage terminally ill people) who needed me to fill out a death certificate. Sleep deprivation manifested as bouts of anger and despair mixed in with some euphoria, along with other sensations I’ve not had before or since. I remember once sitting with the family of a patient in critical condition, discussing an advance directive—the terms defining what the patient would want done were his heart to stop, which seemed likely to happen at any minute. Would he want to have chest compressions, electrical shocks, a breathing tube? In the middle of this, I had to look straight down at the chart in my lap, because I was laughing. This was the least funny scenario possible. I was experiencing a physical reaction unrelated to anything I knew to be happening in my mind. There is a type of seizure, called a gelastic seizure, during which the seizing person appears to be laughing—but I don’t think that was it. I think it was plain old delirium. It was mortifying, though no one seemed to notice.

Why the ingrained expectation that women should desire to become parents is unhealthy

In 2008, Nebraska decriminalized child abandonment. The move was part of a "safe haven" law designed to address increased rates of infanticide in the state. Like other safe-haven laws, parents in Nebraska who felt unprepared to care for their babies could drop them off in a designated location without fear of arrest and prosecution. But legislators made a major logistical error: They failed to implement an age limitation for dropped-off children.

Within just weeks of the law passing, parents started dropping off their kids. But here's the rub: None of them were infants. A couple of months in, 36 children had been left in state hospitals and police stations. Twenty-two of the children were over 13 years old. A 51-year-old grandmother dropped off a 12-year-old boy. One father dropped off his entire family -- nine children from ages one to 17. Others drove from neighboring states to drop off their children once they heard that they could abandon them without repercussion.

His paranoid style paved the road for Trumpism. Now he fears what’s been unleashed.

Glenn Beck looks like the dad in a Disney movie. He’s earnest, geeky, pink, and slightly bulbous. His idea of salty language is bullcrap.

The atmosphere at Beck’s Mercury Studios, outside Dallas, is similarly soothing, provided you ignore the references to genocide and civilizational collapse. In October, when most commentators considered a Donald Trump presidency a remote possibility, I followed audience members onto the set of The Glenn Beck Program, which airs on Beck’s website, theblaze.com. On the way, we passed through a life-size replica of the Oval Office as it might look if inhabited by a President Beck, complete with a portrait of Ronald Reagan and a large Norman Rockwell print of a Boy Scout.

Since the end of World War II, the most crucial underpinning of freedom in the world has been the vigor of the advanced liberal democracies and the alliances that bound them together. Through the Cold War, the key multilateral anchors were NATO, the expanding European Union, and the U.S.-Japan security alliance. With the end of the Cold War and the expansion of NATO and the EU to virtually all of Central and Eastern Europe, liberal democracy seemed ascendant and secure as never before in history.

Under the shrewd and relentless assault of a resurgent Russian authoritarian state, all of this has come under strain with a speed and scope that few in the West have fully comprehended, and that puts the future of liberal democracy in the world squarely where Vladimir Putin wants it: in doubt and on the defensive.

The same part of the brain that allows us to step into the shoes of others also helps us restrain ourselves.

You’ve likely seen the video before: a stream of kids, confronted with a single, alluring marshmallow. If they can resist eating it for 15 minutes, they’ll get two. Some do. Others cave almost immediately.

This “Marshmallow Test,” first conducted in the 1960s, perfectly illustrates the ongoing war between impulsivity and self-control. The kids have to tamp down their immediate desires and focus on long-term goals—an ability that correlates with their later health, wealth, and academic success, and that is supposedly controlled by the front part of the brain. But a new study by Alexander Soutschek at the University of Zurich suggests that self-control is also influenced by another brain region—and one that casts this ability in a different light.

Modern slot machines develop an unbreakable hold on many players—some of whom wind up losing their jobs, their families, and even, as in the case of Scott Stevens, their lives.

On the morning of Monday, August 13, 2012, Scott Stevens loaded a brown hunting bag into his Jeep Grand Cherokee, then went to the master bedroom, where he hugged Stacy, his wife of 23 years. “I love you,” he told her.

Stacy thought that her husband was off to a job interview followed by an appointment with his therapist. Instead, he drove the 22 miles from their home in Steubenville, Ohio, to the Mountaineer Casino, just outside New Cumberland, West Virginia. He used the casino ATM to check his bank-account balance: $13,400. He walked across the casino floor to his favorite slot machine in the high-limit area: Triple Stars, a three-reel game that cost $10 a spin. Maybe this time it would pay out enough to save him.

“Well, you’re just special. You’re American,” remarked my colleague, smirking from across the coffee table. My other Finnish coworkers, from the school in Helsinki where I teach, nodded in agreement. They had just finished critiquing one of my habits, and they could see that I was on the defensive.

I threw my hands up and snapped, “You’re accusing me of being too friendly? Is that really such a bad thing?”

“Well, when I greet a colleague, I keep track,” she retorted, “so I don’t greet them again during the day!” Another chimed in, “That’s the same for me, too!”

Unbelievable, I thought. According to them, I’m too generous with my hellos.

When I told them I would do my best to greet them just once every day, they told me not to change my ways. They said they understood me. But the thing is, now that I’ve viewed myself from their perspective, I’m not sure I want to remain the same. Change isn’t a bad thing. And since moving to Finland two years ago, I’ve kicked a few bad American habits.

A professor of cognitive science argues that the world is nothing like the one we experience through our senses.

As we go about our daily lives, we tend to assume that our perceptions—sights, sounds, textures, tastes—are an accurate portrayal of the real world. Sure, when we stop and think about it—or when we find ourselves fooled by a perceptual illusion—we realize with a jolt that what we perceive is never the world directly, but rather our brain’s best guess at what that world is like, a kind of internal simulation of an external reality. Still, we bank on the fact that our simulation is a reasonably decent one. If it wasn’t, wouldn’t evolution have weeded us out by now? The true reality might be forever beyond our reach, but surely our senses give us at least an inkling of what it’s really like.

A report will be shared with lawmakers before Trump’s inauguration, a top advisor said Friday.

Updated at 2:20 p.m.

President Obama asked intelligence officials to perform a “full review” of election-related hacking this week, and plans will share a report of its findings with lawmakers before he leaves office on January 20, 2017.

Deputy White House Press Secretary Eric Schultz said Friday that the investigation will reach all the way back to 2008, and will examine patterns of “malicious cyber-activity timed to election cycles.” He emphasized that the White House is not questioning the results of the November election.

Asked whether a sweeping investigation could be completed in the time left in Obama’s final term—just six weeks—Schultz replied that intelligence agencies will work quickly, because the preparing the report is “a major priority for the president of the United States.”

Democrats who have struggled for years to sell the public on the Affordable Care Act are now confronting a far more urgent task: mobilizing a political coalition to save it.

Even as the party reels from last month’s election defeat, members of Congress, operatives, and liberal allies have turned to plotting a campaign against repealing the law that, they hope, will rival the Tea Party uprising of 2009 that nearly scuttled its passage in the first place. A group of progressive advocacy groups will announce on Friday a coordinated effort to protect the beneficiaries of the Affordable Care Act and stop Republicans from repealing the law without first identifying a plan to replace it.

They don’t have much time to fight back. Republicans on Capitol Hill plan to set repeal of Obamacare in motion as soon as the new Congress opens in January, and both the House and Senate could vote to wind down the law immediately after President-elect Donald Trump takes the oath of office on the 20th.